Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
  • A61F2/16—Intraocular lenses
  • A61F2/1662—Instruments for inserting intraocular lenses into the eye
  • A61F2/1678—Instruments for inserting intraocular lenses into the eye with a separate cartridge or other lens setting part for storage of a lens, e.g. preloadable for shipping

Definitions

• the present invention relates to a folding cartridge of an ophthalmic implant.
• the implant is injected into the patient's eye via an injection cannula, being pushed by a piston through this cannula.
• the implant is wound on itself in a spiral around a diametral direction connecting the two arms of the implant.
• the winding of the spiral implant is referred to as folding and is performed in a folding cartridge.
• This cartridge comprises the injection cannula and is adapted to be reported after loading on an injection mechanism comprising a support body and a sliding pusher.
• the spiral winding of the implant is carried out by pushing the implant through the cannula, which cannula has for this purpose a frustoconical inner surface whose diameter varies from the duct. confining the implant to the exit end.
• the spiral winding of the implant is initiated during the bringing together of the two branches while the implant is maintained between the two channels.
• the two channels provide a reconciliation of the opposite edges of the implant so that it substantially forms a cylinder.
• the two opposite edges should overlap, one going inside and one going outside. This overlap occurs randomly in one direction or the other, in particular according to the initial positioning of the implant by the surgeon between the two channels.
• the object of the invention is to propose a folding cartridge that avoids damage to the implant during its folding phase.
• the subject of the invention is a folding cartridge of the aforementioned type, characterized in that in the contiguous position of the two branches, at least two of the banks opposite the two channels are offset transversely to the duct in the joining plane of the two branches so that a branch defines a bearing shoulder of the implant projecting opposite the channel formed in the other branch.
• the cartridge comprises one or more of the following characteristics:
• the shoulder has in the junction plane an average width measured transversely to the direction of the channels between 0.1 and 0.8 mm;
• the two shifted edges are further from the axis of articulation of the two branches that the other two banks, which other banks are combined when the two branches are contiguous;
• the cartridge comprises an injection cannula with an internal convergent surface in the extension of the confinement conduit of the implant when the two branches are contiguous;
• the two channels are of substantially semicircular or semi-elliptical section;
• the shoulder is substantially plane and the axis of the duct formed by the two channels extends substantially in the plane defined by the shoulder;
• each branch has, beyond the channel, on the opposite side to the axis of articulation, a maneuvering wing and the shoulder extends an operating wing of one of the branches;
• the two branches have, in the vicinity of the banks of the channels, outside the channels, complementary interlocking profiles protruding and recessed dimensioned so that the profiles are nested when the two branches are contiguous.
• the invention also relates to an implant injector comprising a cartridge as defined above and an injection mechanism comprising a cartridge connecting body and a pusher adapted to push the implant contained in the cartridge.
• FIG. 2 is a perspective view of the injector of Figure 1, the cartridge being partially covered with its protective case;
• Figure 3 is an exploded perspective view of the open folding cartridge, the protective case and the piston;
• Figure 5 is a cross-sectional view of the cartridge taken along the V-V plane of Figure 4.
• Figure 6 is a sectional view of the cartridge taken along the line VI-Vl of Figure 7;
• Figure 6A is an enlarged view of a portion of Figure 6;
• Figure 7 is an elevational view of the closed folding cartridge
• - Figure 8 is a sectional view of the cartridge taken along the line VIII-VIII of Figure 6 during the displacement of the implant
• Figure 9 is a cross-sectional view of the folding cartridge as the two branches approach each other showing a poor positioning of the implant.
• the implant injector 10 shown in FIG. 1 is intended to introduce into the patient's eye an ophthalmic implant 11 visible in FIG. 4 and comprising in particular a lens generally having the shape of a disc.
• the injector comprises a folding cartridge 12 containing the implant to be injected and an injection mechanism 14 formed of a tubular body 16 having at one end means for fastening the folding cartridge and a pusher 18 slidably mounted through the body in the extension of the folding cartridge.
• the body 16 comprises a tube 20 having at a rear end a peripheral collar 22 forming a finger support. At its opposite end, the tube 20 has anti-slip footprints 24 facilitating its gripping.
• the tubular body 16 is slotted at its end opposite to that through which the pusher 18 enters a notch 26 adapted to receive a radial protrusion of the folding cartridge 12 and allowing axial connection of the cartridge 12 and the body 16.
• the notch 26 has at its end opening at the end of the tube 20 a narrow passage extended by a flared lumen allowing a bayonet connection of the cartridge 12 and the body 16.
• the pusher 18 has an actuating rod 28 own to pass right through the tube 20 and at the rear end of the rod 28 a pellet 30 forming a finger rest.
• the injector further comprises a protective case 32 of the injection end of the folding cartridge. This case is visible with the cartridge opened in Figure 3.
• the cartridge 12 has two branches 34, 36 hinged relative to each other about a hinge 38 whose axis extends parallel to the axis XX of injection of the implant defined by the cartridge.
• the two branches articulated are extended along the injection axis XX on one side by a cannula 40 and on the other side by a sleeve 42 for receiving an injection piston 44 adapted to be displaced along the axis XX under the The action of the pusher 18.
• the two branches 34, 36 each have, in the vicinity of the hinge 38, a channel 46, 48. These two channels extend parallel to one another and open the door. one facing the other when the two branches are contiguous. These channels extend parallel to the direction of articulation of the hinge. They each have a semi-circular section or more precisely semi-elliptic.
• the channels 46, 48 are delimited longitudinally by substantially parallel banks. Thus, each channel is delimited by an inner edge 46A, 48A formed along the hinge 38. These banks extend parallel to one another and are such that when the two branches 34, 36 are contiguous, the two Inner banks 46A, 48A are strictly aligned and merged, the two channels extending continuously and tangentially at the inner adjoining edges 46A, 48A.
• the two channels 46, 48 are on the other side delimited by two outer edges 46B, 48B arranged at a distance from the hinge 38.
• the outer edges 46B, 48B are offset transversely with respect to the axis of the duct as will be described. in detail in the following so that when the two branches are contiguous, the two outer edges 46B, 48B are shifted to one another without being confused by forming between them a shoulder 49 visible in Figure 6A.
• the two banks 46B, 48B are concurrent when the two branches are contiguous at an end point located immediately at the outlet of the sleeve 42.
• the shore 48B diverges from the shore 46B towards the cannula 40 away from the bank 48B inwardly of the duct defined by the two channels.
• the shoulder 49 is generally triangular or trapezoidal, its width increasing in the direction of the cannula 40.
• the shoulder 49 has an average width measured perpendicular to the direction of the channels 46, 48 between 0.1 mm and 0 , 8 mm. More precisely, and taking into account its triangular shape, its width varies from 0 mm in the vicinity of the sleeve 42 to a value between 0.2 and 1 mm and in particular equal to 0.4 mm at the level of the cannula 40.
• shoulder 49 is flat.
• the two channels have a different width, the banks 46A, 46B of the channel 46 having a spacing greater than the edges 48A, 48B of the channel 48 away from the sleeve 42.
• Each branch 34, 36 has beyond the channel 46, 48 associated on the opposite side to the hinge 38 a maneuvering wing 50, 52.
• These two wings are of generally rectangular shape. They have one facing each other flat bearing surfaces 5OA, 52A adapted to be applied to one another when the two branches are contiguous. These wings extend radially with respect to the hinge 38. The shoulder 49 extends in the extension of the flat surface 52.
• the wings 50, 52 have respective notches 54, 56 arranged head to tail.
• the wings 50, 52 comprise on the bearing surface 50A, 52A, at the right of the notch of the complementary wing snap projections 58, 60.
• These projections are adapted to be received in the notches 54, 56 formed on the wing opposite. They have, at their end facing complementary resilient engagement profiles having associated profiles protruding and recessed for maintaining the two branches contiguous to each other, the channels together forming a closed section conduit.
• the piston 44 is fixed to the end of the pusher 18 and is able to circulate through the sleeve 42, the duct delimited by the two channels 46, 48 and the cannula 40.
• the inner conduit of the sleeve 42 is substantially circular in section and constant along its length.
• the inner duct delimited by the cannula 40 converges channels 46, 48 towards the free end of the cannula.
• the cannula has a frustoconical surface of decreasing section of the channels 46, 48 towards the injection end.
• the cannula 48 has two locating slots 70 adapted to cooperate with projections 72 formed in the protective case.
• the protective case 32 consists of a housing 73 having an opening 74 for introducing the cannula 40 formed in the center of an end face.
• the length of the case is greater than the length of the cannula.
• the opening 74 is bordered on more than half of its periphery by a lip 76 having at each end bearing surfaces 78, 80 extending radially relative to the opening 74 and adapted to receive the wings 50 52 of the cartridge when the branches 34, 36 are spaced apart as shown in FIG. 4.
• the folding cartridge 12 is illustrated in the open position in FIGS. 4 and 5 while an implant 11 is disposed between the channels 46, 48.
• an implant has, as known per se, a lens 92 consisting of a that transparent and two arcuate arms 94, 96 symmetrical to each other with respect to the axis of the lens. The two arms are diametrically opposite to the lens.
• the implant is formed of an elastically deformable polymeric material.
• the implant is shaped while the cannula of the cartridge is held in the protective case, the two wings resting on the surfaces 78, 80.
• the lens is placed in abutment in the channels 46, 48 in their middle part, that is to say in the region of the projection 62 and the recess 64, the two arms 94, 96 being disposed on either side respectively of the side of the sleeve 42 and the cannula 40.
• the implant 11 is in contact on both sides with the surfaces of the channels 46, 48 and bears on them at substantially diametrically opposite points.
• the bringing together of the two branches 34, 36 by tilting around the articulation 38 causes the implant 11 to fold around an axis parallel to the axis of the channels 46, 48 when this folding is initiated by the surgeon for example by pressing a pliers in the center of the implant.
• the central portion of the lens is applied to the hinge 38 while the opposite edges of the lens are brought closer to each other in contact with the channels 46, 48 as illustrated in FIG. branches are contiguous.
• the shoulder 49 extends over most of the length of the channels 46, 48.
• the opposite edges of the lens overlap by ensuring that the edge bearing on the shoulder 49 is outside the curved edge by the channel 48 through the shoulder 49.
• the presence of the shoulder 49 ensures that during the insertion of the implant through the cannula, and during the continuation of the spiral winding of the implant, the opposite edges are correctly offset radially. and superimposed, allowing a satisfactory winding of the implant on itself, without the two edges are supported on each other.
• the direction of rotation of the implant is guaranteed since imposed by the shape of the channels 46, 48 and the presence of the shoulder 49.
• the presence of the protrusion 62 and the complementary recess 64 ensures that, in the case of initial poor positioning of the implant, it is difficult to join the two wings to one another as illustrated. in fact, if one of the edges of the implant escapes from one of the channels 46, 48, this edge constitutes a barrier interposed between the projection 62 and the cavity 64 preventing the protrusion from penetrating in the recess. Thus, the surgeon feels a hard point when attempting to bring the two limbs together and is thus informed of the incorrect positioning of the implant.

Landscapes

• Health & Medical Sciences (AREA)
• Ophthalmology & Optometry (AREA)
• Cardiology (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Transplantation (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Prostheses (AREA)

Applications Claiming Priority (2)

Publications (2)

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Family Applications (1)

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• 2005
  • 2005-11-09 FR FR0511421A patent/FR2892920B1/fr not_active Expired - Fee Related
• 2006
  • 2006-11-09 US US12/093,017 patent/US8109938B2/en not_active Expired - Fee Related
  • 2006-11-09 EP EP20060831099 patent/EP1945140B1/de not_active Ceased
  • 2006-11-09 WO PCT/FR2006/002499 patent/WO2007054645A2/fr active Application Filing

Non-Patent Citations (1)

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